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February 24, 2021
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Asthma risk may be elevated in atopic dermatitis

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Individuals with atopic dermatitis carried an elevated risk for asthma compared with those who did not have AD, according to a study.

“It is well established that asthma is common in patients with atopic dermatitis,” Nanna Ravnborg, MS, of the department of dermatology and allergy at Herlev and Gentofte Hospital at the University of Copenhagen and of the Copenhagen Research Group for Inflammatory Skin in Denmark, and colleagues wrote.

The systematic review and meta-analysis included data for 39,503 articles from the PubMed, EMBASE, LILACS and SCOPUS databases. This group of papers was ultimately culled down to 213 studies and an overall study population of 688,927 patients included in the final quantitative analysis.

The aim was to determine the prevalence of asthma and other respiratory symptoms in study participants who have AD. The researchers also assessed for correlations between AD and asthma.

Results showed an overall pooled prevalence of asthma of 25.7% (95% CI, 23.7-27.7) in the AD group compared with 8.1% (95% CI, 7.0-9.4) among controls.

These prevalence rates yielded a significant correlation between AD and asthma as compared with controls (OR = 3.03; 95% CI, 2.64-3.47). This trend persisted in studies in which both AD and asthma were physician diagnosed (OR = 3.01; 95% CI, 2.41-3.77). The association was slightly weaker in studies in which asthma was defined as a wheeze (OR = 2.46; 95% CI, 2.08-2.90).

The researchers acknowledged the limitation that definitions and diagnostic criteria for both AD and asthma were not uniform across data sets. However, when they conducted an analysis in which both AD and asthma were physician diagnosed, the prevalence rate of asthma in the AD cohort remained elevated, at 21% (95% CI, 17.9-24.3).

The prevalence of asthma was 28.8% (95% CI, 20.7-37.6) in patients with AD in studies in which asthma was defined as a wheeze, 26.3% (95% CI, 23.5-29.1) in studies of children with AD and 21.8% (95% CI, 18.4-25.4) in studies of adults with AD.

Rates of asthma were comparable among women and men with AD.

The correlation between AD and asthma may be due to shared features of type 2 immunity and elevated IgE levels, according to the researchers. “Asthma is a common comorbidity of AD,” they wrote. “Physicians should be cognizant of this relationship and address asthma symptoms in their patients.”